Emergency department overcrowding in Australia’s public hospitals is creating access block with patients waiting for hours in the ED or giving up and going home, according to articles published in the latest Medical Journal of Australia.

Access block is defined as the percentage of all patients admitted, transferred or dying in the emergency department whose total ED time exceeds eight hours.

Professor George Braitberg, Professor of Emergency Medicine, Monash University in Melbourne, says reduced bed numbers, an ageing population, and current management of supply and demand are mostly to blame for access block.

“Initiatives to prevent access block should be aimed at long-term structural changes to bed availability to meet the needs of a complex and ageing population,” Prof Braitberg says.

“We know access block causes ambulance diversion, increased length of patient stay, and increased patient mortality.

“There is also a high correlation between overcrowding and patients who leave an ED without treatment.”

In a related study in the journal, Professor George Jelinek, Professor of Emergency Medicine at the University of Western Australia, and his co-author Dr Jacqui Hall, former Registrar of Emergency Medicine at Sir Charles Gairdner Hospital, found busy times were linked to high numbers of patients who did not wait (DNW).

Prof Jelinek said there was a strong association between increased rates of DNW patients and evening shifts or Sundays, suggesting fewer patients wait for medical care when the ED is busiest and when waiting times are at their peak.